Bil. 4b The LUCare1 Research Programme – Towards evidence-based
practices for health promotion, care and rehabilitation in relation to long-term illness
The LUCare Research Programme aims for the development of evidence-based practices for health promotion, care and rehabilitation in relation to long-term illness. It emanates from the health and care science research at the Department of Health Sciences (DHS), at the Faculty of Medicine, Lund University (LU), or is performed in close collaboration with scientists from DHS.
The research includes five different but closely connected key areas; Health promotion, Everyday life, Person-centred care, Mechanisms and processes, and Implementation in five research domains; Child and Family Health; Mental Health; Acute Care; Physical Health and Rehabilitation; and Ageing and Old Age. Research of relevance for long-term illness within these domains is presented in Appendix I.
The demands on health care and social services increase rapidly, and are likely to do so in the future as well, partly due to changes in the consumption of health care, partly to population ageing. A specific challenge concerns the already large and growing population of persons with long-term illnesses, and to meet their complex and costly care and treatment needs. Long-term illness is the leading cause of mortality worldwide, accounting for 60% of deaths in the world and 86% in Europe (http://www.euro.who.int/mediacentre/PR/2006/20060908_1), and should be attended to for all age groups. Adverse conditions in childhood manifest in a risk for long-term illness and poor labour market performance in the future and add to future health problems
One core task for health and care research is to develop new and relevant knowledge but also to explore new ways of providing high quality health care and social services. There is a lack of knowledge concerning efficient modes of implementing research-based methods into the health care and social service organisations, and several practice fields do not have an evidence-base for such implementation. Evidence-based practice is an approach in which the clinician is aware of the evidence that bears on his or her clinical practice, and the strength of that evidence. The definitions also typically stress the importance of combining individual clinical expertise and the best available external evidence (Sackett et al., 1996).
Long-term illness is defined differently depending on context but mainly concerns both the duration and the impact of the illness or injury. A generally accepted definition of a paediatric long-term health condition is one that interferes with the child’s daily functioning for more than three months per year, results in hospitalisation for more than one month per year, or is likely to do either of these (Perrin et al., 1993). Regarding mental illness the term Severe Mental Illness (SMI) is often used to denote lasting and severe conditions. The criteria for SMI have been set to be duration of two years or more and a rating of psychosocial functioning of 50 or below on the Global Assessment of Functioning scale (Ruggeri et al., 2000). The area of physical long-term illness is wide and no uniform definition seems to have been proposed. However, the subjective perception of a longstanding problem, affecting or likely to affect oneself over a period of time, is the essence in several descriptions. Ageing and old age is more or less accompanied by increasing physical and/or mental long-term illnesses, leading to declining activity and participation. When it comes to old age the issue of frailty seems to be more relevant.
Vision, Mission & Goals
Our vision is to establish a research centre that is outstanding nationally and competitive internationally, for strong inter- and multidisciplinary research and research-based education within the field of health and care science in order to strengthen and increase the research productivity and infrastructure.
Our mission is to improve the health and quality of life of people with long-term illnesses in all ages. This will be made through the development and implementation of evidence-based practices for people with long term illnesses, and health promotion for the population at large, not only in Sweden but beyond. Good health is important during the entire lifespan, and is related to physical, social and cultural environments. We believe that high-quality health and care research can and should have impact on the health and well-being of the population and the provision of health care, so that people’s possibilities of leading healthy and satisfying lives will increase.
The overall goals of our activities will be to:
• foster inter- and multidisciplinary research
• enhance research capabilities and to recruit new investigators
• develop and refine research methods
• develop information models/systems to facilitate patient-provider interaction
• dissiminate research findings to the clinical arena
• inform professionals and laypersons about research activities and results
• integrate research into all education in the three Bologna cycles
• contribute to the international development of conceptual, theoretical and methodological frameworks for health and care sciences research
• plan and ensure a generation shift by producing a group of scholars with excellent skills for inter- and multidisciplinary translational research, well-trained and prepared to continue the transfer of knowledge into qualified national and international research activities
Expected outcomes in a 10-year perspective:
Health and care research is complex and protracted. The direct benefits of a particular research project may not emerge for several years. In a ten-year perspective, the most prioritised outcomes for our research are:
• An improved understanding of the experience and needs among persons and families affected by long-term illnesses.
• That some adverse factors of importance for capabilities and health later in life are identified early on and that we have identified risk factors and preventive factors predicting injury/disorder/disease and/or slowing the detrimental progress caused by the condition.
• That a larger proportion of those with long-term illness will have access to work, evidence- based meaningful daily activities and housing support.
• That we have established improved and novel methodology for assessment and evaluation of body functions and structures, activity, participation, contextual factors and health in relation to long-term illness in all ages, and have evaluated them in trials.
• That evidence-based models for case management and for person-centred care at affordable cost-benefit ratios are used for people with long-term illness in different ages in health care practices and social services.
• That evidence-based models for the promotion of healthy living - for example better life styles (in terms of reduced smoking, overweight etc.), more physical activity and alcohol cessation - are developed and implemented at hospitals and in primary care settings.
• That knowledge on how to design supportive environments for activity, participation and health for older persons and persons with long term illness are utilized in ordinary environmental planning and building processes, by the municipalities and by private enterprises.
The LUCare Working Structure
The LUCare working structure is based on previous, existing and future research in the inter-and multidisciplinary research domains of Child and Family Health; Mental Health; Acute Care;
Physical Health and Rehabilitation; and Ageing and Old Age2, further presented in Appendix I.
The research is diverse, has not only an individual but also a family and societal perspective and reflects the research expertise of the researchers. The research designs and methodologies used span from randomized, controlled studies and statistical analyses to case studies, document analyses and in-depth interviews applying inductive designs and methods. They also include methodological development and optimization of valid and reliable measures concerning identification of different conditions and outcomes. Moreover, mixed methods designs are applied, taking advantage of different aspects of the person and the context and outcome measures related to health.
In the perspective of long-term illness our research approach is focused on a number of particular key areas; Health promotion, Everyday life, Person-centred care, Mechanisms and processes, and Implementation (see Figure 1). These different key areas are defined as follows:
1. Health promotion is the process of enabling people to increase control over their health and its determinants and thereby improve their health. It moves beyond a focus on individual behaviour towards a wide range of social and environmental inter-ventions.
2. Everyday life is used to denote people’s everyday doings and interactions with others, such as gainful work, household chores, personal care, leisure activities, play, socialising, transportation, use of mass media etc. A balance between these areas is necessary for a satisfactory everyday life.
3. Person-centred care means that the care is tailored to the individual person’s needs, that a shared decision making model is used health and care, and that the individual person’s experiences and expectations of the illness are taken into account in all aspects of care and treatment.
4. Mechanisms and processes determine impairments and disabilities related to injuries/
diseases/disorders in order to help in designing and improving interventions but can also be about processes in systems of care provision.
5. Implementation includes a specified set of activities designed to put into practice a programme of known dimensionsusing identified techniques effective for encouraging the translation of evidence into practice.
Towards evidence‐based
practices for health promotion,
care and rehabilitation in relation to long‐
term illness
2. Everyday life 1. Health
promotion
5. Implemen‐
tation
4. Mechanisms and processes
3. Person‐centred care
Figure 1. Towards evidence-based practices for health promotion, care andrehabilitation in relation to long-term illness, as reflected by the key areas.
In the LUCare context Health Promotion constitutes an ultimate goal towards which all of the included research aims in the long run, but it also forms a specific key area since some research has health promotion as the immediate and only target. The LUCare programme focuses on people with long-term illness and the reseach is concentrated on the selected key areas.It is important to note that research in the different key areas is interrelated and mutually underpinning each other. A major part in the different key areas constitutes of intervention studies focused on improving health or alter the course of disease, improved and adjusted living and care environments, and changes in routines, systems for care and support to families and staff.
Research findings from these areas together form the growing evidence-base for a successive knowledge translation, further implementation in practice, and research regarding Implementation.
Methodological framework
Interventions constitute the basis for the development of evidence-based practices in health care and support. Given the challenges facing this sector of society, interventions are often very complex and involve many mechanisms, with a range of interacting outcomes. The development, evaluation and implementation of such interventions present a number of problems, in addition to the practical and methodological difficulties that any successful evaluation must overcome. The recently updated framework for trials of complex interventions (MRC, 2008) constitutes a methodological basis for the LUCare programme (Figure 2). The included research projects have reached varying stages, and thereby cover different steps of the model. However, in applying this model, the implementation stage will continuously be substantiated by inclusion of recent research developments.
Figure 2. A model for developing and evaluating complex interventions (MRC, 2008).
In order to understand and to make changes in complex health care systems, the problems/questions have to be multi-dimensionally handled. Our starting point is that it is not possible to reduce the complexity in the health care and social services system; instead it is an important precondition for the development of evidence-based practices. This is closely related to implementation science, i.e. the investigation of methods, interventions, and variables aiming to influence individuals and organisations to adopt evidence-based practices in order to improve clinical and operational decision-making. Implementation science also includes testing the effectiveness of interventions to promote and sustain use of evidence-based health care practices (Fixsen et al., 2005; Titler et al., 2007).
Collaborating centres
Of utmost importance for the LUCare research programme are the collaborating centres hosted by the DHS, The Faculty of Medicine and LU. Several of the LUCare projects are performed in collaboration with or within the frame of these research milieus.
Centre for Ageing and Supportive Environments, CASE was established in 2007 as one out of two national centres of excellence for research on ageing with 10-year funding from the Swedish Council for Working Life and Social Research (FAS), with additional 5-year funding for a graduate school within the centre. Five research teams are included, from the Faculties of Medicine, Engineering, and Social Sciences, LU. There is strong emphasis on translating research results to practical solutions to the benefit of societal planning; in housing, public indoor and outdoor environments including traffic and public transportation, as well as in health promotion, prevention, rehabilitation, and social services. Contacts are well established with universities and authorities in all Nordic and many European countries, as well as in the U.S. and Canada.
http://www.med.lu.se/english/case
Centre for Evidence-based Psychosocial Interventions, CEPI is a Swedish national knowledge centre, coordinated from LU, and based on collaboration between research groups at four Swedish universities. The main mission of CEPI is to initiate and carry out research in the field of psychosocial interventions and life situation in the community for people with a severe mental illness, to promote dissemination of research and participate in implementation of evidence based interventions. CEPI also has a user participation orientation in research and implementation studies. CEPI is financed by grants from the Swedish Ministry of Health and Social Affairs.
http://www.cepi.nu/%7B944C7CDA-268C-4D3F-B566-A580184894D2%7D
In collaboration with Region Skåne and Malmö University, the Department of Health Sciences has established a four-year funded Research Platform for Disability Studies, aiming to strengthen inter- and multidisciplinary research within the area of habilitation with a strong collaboration with clinical practice. The platform has close links to HAREC (Center for handicap and rehabilitation research) at LU. http://www.harec.se/
Collaborating closely with primary health care personnel and others in the fields of health and medical care, the Center for Primary Health Care Research at the Faculty of Medicine works to increase knowledge about health via highly relevant, high-quality research and teaching.
http://www.med.lu.se/english/cpf
The Swedish Institute for Health Sciences (Vårdalinstitutet [VI]) that started 2001 is a national multidisciplinary research institute with focus on health care research. The Institute is integrated into the research environments at LU and University of Gothenburg. The collaboration with LU faculties is well developed and more than one third of the researchers are appointed at LU. Current VI research platforms address health care and social service related to people living with long-term illness (since 2007 mainly children), mental health problems, and ageing, care and social service for older people. http://www.vardalinstitutet.net
Research Quality
During 2008 the quality of all research at LU was evaluated by 17 external panels in the Research Quality Assurance for the Future (RQ-08) evaluation
(http://www.lu.se/lund-university/research/research-evaluation---rq08). A majority of the PIs of the LUCare programme are affiliated with the DHS, and the RQ-08 assessed the quality of the research produced at this department as very good to excellent. The panel concluded that the research has contributed to, and has a great future potential for, the advancement of research-based knowledge into societal applications in relevant research fields. The DHS was described as a place where dynamic research is taking place across many diverse but often neglected areas of vital societal concern. There is strong collaboration within the DHS and with the rest of the Faculty of Medicine and other faculties at LU, as well as with a major university hospital, collaborating centers and international partners.
The RQ-08 panel identified a number of research groups approaching excellent quality and found many examples of emerging innovative interdisciplinary research cultures. These were seen as considerable achievements, in particular against the background that the research has been developed only during a 10-15 year period, in parallel with the establishment of sustainable education programmes with high academic standing. Evidenced by the strong external funding for the period 2003-2007 (SEK 164 million) and publication performance at world average (on average about 4 articles in refereed journals per year/FTE number of academic staff), the research productivity was estimated as high and of unusually equal merit for all disciplines, compared to corresponding institutes in Sweden and beyond. The panel highlighted the collaboration with Region Skåne (RS), in service development and implementation of interventions, not only within health care but also in a broader societal context. The evaluation was not addressing the research domains targeted in the LUCare programme, but the research quality of the specific research groups concerned, as follows.
The research domain Child and Family Health is based on research on Health and Care of Women and Children (PI: Hallström), in the RQ-08 described as productive on an international
level and graded as Very good, undertaking randomised controlled trials (RCTs) and translational research in a multi-disciplinary setting. The research ranges from pregnancy, childbirth, pre term birth and illness in childhood to studies with adults who became ill in childhood, from clinical, ethical and health economic aspects. The research is of high quality and translational in the paediatric clinical practice, providing knowledge for shaping of policies aiming at enhancing child health and also significantly contributing to our understanding of health-related behaviour of the family.
Mental health research emanates from several interrelated, multidisciplinary research groups. Mental health research (PI: Hansson) focuses on serious mental health problems, with a strong emphasis on implementation. There are a number of high quality publications, and the research in this area has been of great prospect nationally and internationally and has a mature evidence-base. Among prioritised areas are common but scarcely researched clinical interventions, such as housing and daily activities for people with severe mental illness, and their efficacy.
Another research area concerns outreach programs and work rehabilitation, where there are international studies but a lack of Swedish studies.
Research on substances use disorders (PI: Öjehagen, representing also Prof. Em.
Berglund’s research) is internationally recognized, and according to the RQ-08 Excellent. The studies, including RCTs, focus on the long-term progress of alcohol and drug dependence and the development of better intervention and treatment methods. Addictions or hazardous use of alcohol cause severe health and social difficulties and this research targets at-risk groups for successful interventions. The unit is highly focused and provides good evidence of clear thinking across different methodologies to provide evidence for the effects of alcohol and treating alcohol problems. They use state-of-the-art health services research methods to develop and test their interventions, and collaborate with health economics to test such effects. Another focus concerns comorbidity between psychiatric and substance use disorders, hazadous and harmful use of alcohol, legal and illegal drugs among patients with psychiatric disorders, including those with suicidal behaviour, and early intervention of stress among university students. This research group is currently in a transitional phase with a new professor in clinical alcohol research, specifically prevention, taking office 1 May 2010.
Occupational therapy (OT) research (PI: Eklund) explores relationships between engaging activities and health, investigates outcomes of interventions, and develops instruments, models and theories. The links between individual experiences of occupational dysfunction and health and wellbeing is a particularly strong area. The RQ-08 identified this research group as nationally important for OT research; the grading was Very good. In a relatively short time they have developed research in e.g. occupational science to a level which compares favourably internationally. The mental health research is impressive, mostly using the latest advances in qualitative methodology. The external funding and publication rate signifies a productivity level uncommonly found for OT in Europe. Another strong line based on OT and hand surgery, concerns new diagnostic tools and treatment strategies for nerve injury and neuropathy.
Physical health and Rehabilitation (PI: Ekdahl) covers studies of physical and psychosocial function, activity and participation in society among adults, e.g. people with musculoskeletal problems, neurological disorders/diseases, breast cancer or sport injuries. In this group, graded as Very good by the RQ-08 panel, new evidence-based interventions have been developed and are in progress, such as Tai Chi, Basic Body Awareness Therapy, programs for life- style and behavioural change as well as for work rehabilitation. Several studies concern work capacity and programs for physical activity on prescription have been developed and evaluated, all in cooperation with primary health care and municipalities. There are also qualitative studies
concerning psychosocial aspects, which internationally are quite rare. A research line based on physiotherapy and orthopaedics was evaluated as Excellent and aims to establish the role of muscle function and exercise in osteoarthritis.
When it comes to research targeting Ageing and Old Age, the core is produced by two research groups. Besides empirical results, these groups have made methodological contributions for application in a wide range of studies, including instrument development, novel statistical techniques, qualitative methodology and mixed-methods approaches. This research is internationally leading and by the RQ-08 ranked as Excellent/very good. The research undertaken in PI: Edberg’s group has four different foci; care of the elderly and the oldest old, palliative care and people living with long-term diseases. Of particular interest are the oldest old, their health, health care consumption, informal care and quality of life. Other important issues are chronic pain and pain relief, intensive care in neurology/neurosurgery, and palliative and dementia care. Their research focusing on health care and social service is also promising, with results integrating health care and social services provided by the municipalities/county council. In a RCT, the effects of a case manager and integrated care are being tested (Hallberg). Another internationally competitive research project is that of prioritization in health care (Edberg). The other research group (PI: Iwarsson) concentrates on environmental gerontology based on occupational therapy and geriatric rehabilitation perspectives, in collaboration with traffic planning. The research focuses on person-environment relationships in housing, out-of-home environments and public transportation, including use and need of assistive technology, mobility, safety, and influences on activity, participation and health. Results with societal impact potential are e.g. those of the European ENABLE-AGE and FUTURAGE projects. This research has resulted in internationally acknowledged methodology for studies on housing and health, currently being applied e.g. in a community trial evaluating an evidence-based housing adaptation case management model and in a Finnish implementation project.
A Prioritised Strategic Research Field
The present programme is fully in line with LU’s strategy and research priorities. As stated in LU’s research and education strategy for 2009-2012, life sciences and health & ageing are prioritised research areas. Demonstrated by LU’s commitment to the establishment and development of centres of excellence, such as the VI, CASE and CEPI, this research already has strong support. The most prominent evidence of strategic support is the fact that since 1998, when the University College for the Health Professions was integrated with the Faculty of Medicine, the field of health and care sciences has made significant progress, as exemplified by 88 PhD and 17 Licentiate examinations. From 2005 an onwards, 11 to 14 doctoral students per year have received their doctoral degree.
The proportion of external funding is about one third of the total income of the DHS (42.3 MSEK in 2009) and is increasing (with 8% 2007-2009). The plethora of funding institutes is wide and includes the Swedish Research Council, the Swedish Council for Working Life and Social Research, the Swedish Research Council FORMAS, the Swedish Cancer Foundation, and the European Commission FP5 and FP7. Supplementary income from the VI is about 10 MSEK/year.
Promoting and Safeguarding Scientific Renewal
By strategic planning during the last two years a more coherent research milieu has been aimed at, including research concentration to fewer research foci and improved collaboration within and between research groups. The starting point for our future research is the diversity of already existing projects and research programmes in different stages of progress. In that, the comprehensive knowledge and data bases that have evolved from previous research will be more efficiently utilised and developed. By applying such a “bottom-up” approach the strategy for building up our research is to successively form a coherent composition of inter-related projects, making benefit of the inter-disciplinary traditions and resources available. This approach has potentials for producing synergies and nurturing new research ideas, engaging researchers in creative processes that lead to the the development of new projects. Examples of research foci where integrated research efforts are planned concern housing and housing environments, work rehabilitation interventions, social inclusion in society in terms of research on stigma and discrimination and models of case management. Regarding cooperation within the faculty, one example is that health and care science is included in the LU strategic research field of neuroscience (MultiPark). Another example is that further research on person-centred care for children with long-term illness is planned in collaboration with the newly appointed professor in paediatrics at the Faculty of Medicine.
On the other hand we also use a “top-down” approach, for example by having recruited a senior researcher to develop research in the field of Acute Care for patients with long-term illness.
Another example is the recruitment of a professor in clinical alcohol research, especially prevention (starts May 1st, 2010), which will further develop clinical research for health promotion and healthy living (related to smoking, overweight, physical activity, and alcohol cessation) in the LUCare programme. A new intervention programme, VIP (Very Important Patient), including support and treatment, will in RCTs target both patients with drug abuse and patients with mental and physical long-term illness in hospital and primary healthcare settings. The programme includes screening, intervention and evalution in short-term and long-term follow ups.
Furthermore, we plan to recruite two guest professors during 2010, one in physiotherapy and one in nursing, with the goal of further establishing national and international collaboration in the research of long-term illness.
With the aim of integrating clinical practice, education and research, four joint positions with Region Skåne, all with backgrounds as a nurse, occupational therapist or physiotherapist, have been appointed for permanent posts. Furthermore, a strategy for improving the research in health and care science has been decided upon at the institutional board and is now under implementation. There is, however, still a need to increase the number of permanently employed professors and senior lectures. The fact that only three of the professorships within the area of health and care science at the DHS are being funded from the faculty budget for research is of particular concern.
In order to bridge the upcoming transitional stage and at the same time reinforce a positive development, the Faculty of Medicine and LU overall recruits and supports PhD students and creates opportunities for post-doctoral researchers to improve their qualifications. To date, a few appointments have been advertised specifically for research within the area of health and care sciences.
Active collaboration engagement nurtures the development of health and care sciences, e.g.
through LU’s Universitas 21 membership. Researchers are actively involved in this network for research and education co-operation, e.g. in collaboration with partner universities such as the Fudan University, China, and the University of Queensland, Australia. One PI represents LU as a
partner in an EC-funded coordinated action project for research on ageing (FUTURAGE), one professor is the president of the European Academy of Nursing Science which has held a Marie Curie grant for a postgraduate summer school and one PI is part of the Swedish Brainpower consortium.
The generation shift is a challenge to the sustainability of the attained research strength.
Therefore, for each PI retiring within the next five years a succession plan is being established and a younger senior scientist appointed in good time, in accordance with the LU requirements.
Infrastructure
The majority of the research groups have their premises at the Health Sciences Centre in Lund, which is one out of three main units of the Faculty of Medicine. Within this building, one of the faculty libraries, the IT Department, the Centre for Teaching and Learning, auditoriums and group rooms equipped with the latest technology, computer labs, and restaurant and catering services are located. There is also a complete research laboratory with the latest equipment for the measurement of muscle strength, muscle activity and fatigue. The vast majority of the health care undergraduate programmes are located in this building, as are CEPI, CASE and the VI. Still, there is room and facilities for extended research activities. The LUCare research can benefit from the well established infrastructure of the VI for activities such as post-graduate education, post-doc training and research dissemination.
Available for research purposes, there are longitudinal data bases, specifically created for medical, demographic, and health-economic analyses, combining survey, functional and register data and bio-banking on individuals from the general population and from sub-groups with long- term illness. The Swedish National study on Aging and Care in Skåne (SNAC-Skåne) started in 2001 and is a population-based longitudinal study including 3,000 participants aged 60 years. It comprises a population part and a care system part, in urban and rural areas. The care system database with information on care consumption is particularly strong; to date, more than ten original papers have been published. The SNAC-Skåne data collection includes medical, psychological and physical examinations pertaining to anthropometrics, functioning, medical history, socio-economic conditions, housing, transportation, and much more.
Integration of Research with Three Cycles of Education
As indicated in the expected 10-year outcomes, our ambitions include developing the education and research environment as such. This involves research and education in all three Bologna cycles at the Faculty of Medicine and involves an extensive and longstanding collaboration with the Skåne University Hospital, several local/regional hospitals, primary health care centres and municipalities. This means that the research is rooted and integrated in clinical practice. Research is nurtured from the first exposure to research techniques in the Faculty’s programmes at the basic level (nursing, radiography, midwifery, occupational therapy, physiotherapy, and medicine), through our nursing specialization and Master programmes at the advanced level (in Medical Science, including a Nordic Master in Gerontology [NordMaG], and Sport Sciences,) to the PhD programmes.
As to education on the research level at the Faculty of Medicine, the recent national evaluation likewise stated that the quality is high. Education at the research level and post-doc training programmes are established since 2001 within the VI and since 2007 within CASE, collaborating with the Aging Research Center at the Karolinska Institute, Stockholm. In all, these research schools engage more than 80 PhD students.
Current research activities are well integrated with advanced level and research level education. Most PhD students base their thesis projects on senior researcher’s projects, and during recent years the development seen is that students are increasingly involved in large-scale projects involving national as well as international collaboration. Overall, lecturers are experienced researchers and students are often exposed to their future thesis topics early on in their education.
It should also be noted that there is a possibility for PhD students to take credit of one year of the advanced level studies when going through their research education, allowing for real integration between educational levels and between education and research.
Gender Equality
In contrast to at LU at large, within the health and care sciences the gender balance is the opposite of the usual, with female dominance, and in the LUCare consortium the majority of the PIs and co- workers are women. This is good example of a department where female academic staff is in the majority in the department at a time when most university departments are striving to achieve better equality for women scientists. The current LUCare co-worker composition is summarised in Table 1. The separate research groups, as well as national and international collaborators, are presented in Appendix II.
Table 1. Overview of the current LUCare co-worker composition,a N = 128.
Research domains, N=5
Professor
Senior Scientists, n
Post-docs, n
PhDstudents, n
Others, N
TOTAL, n Child and family
health
1 7 10 7 1 26
Mental health 3 4 12 10 3 32
Acute care 1 5 1 1 8
Physical health &
Rehabilitation
2 9 2 8 0 20
Ageing 3 5 8 13 6 35
TOTAL, n 9 27 41 42 11 128
Women 6 20 36 36 10 108
Men 1 7 5 6 1 20
a Refers to the research groups. Co-workers in the collaborating partners’ teams (see Appendix II) are not included.
References
Fixsen, D.L., Naoom, S.F., Blase, K.A., Friedman, R.M., & Wallace, F. (2005). Implementation research: A synthesis of the literature. http://cfs.fmhi.usf.edu/resources/publications/NIRN_Monograph_Full.pdf
Medical Research Council, MRC. (2008). Developing and evaluating complex interventions: New guidance. United Kingdom.
Perrin, JM., Newacheck, P., Pless, IB. et al. Issues involved in the definition and classification of chronic health conditions. Pediatrics, 1993; 91, 787-93.
Ruggeri, M., Leese, M., Thornicroft, G., Bisoffi, G., & Tansella, M. (2000). Definition and prevalence of severe and persistent mental illness. British Journal of Psychiatry, 177, 149-155.
Sackett, D.L. et al. (1996) Evidence based medicine: what it is and what it isn't. BMJ 312 (7023), 13 January, 71-72.
Titler, M. G., Everett, L., & Adams, S. (2007). Implications for implementation science. Nursing Research, 56, S53-59.
